Comparison of different ureteroscope sizes in treating ureteral calculi in adult patients.

OBJECTIVE: To compare the success and complication rates of a 4.5-6.5F semirigid ureteroscope (S-URS) with an 8.5-11.5F S-URS in treating ureteral stones in adult patients. MATERIALS AND METHODS: Fifty-two patients with ureteral stones, who were treated with 4.5-6.5F S-URS (group 1) and 52 patients who were treated with 8.5-11.5F S-URS (group 2) were compared retrospectively using a matched-pair analysis. The size, lateralization, location, and impaction of the stones and also the patient age, gender, body mass index, and the presence of hydronephrosis were used as the matching parameters. The stones were fragmented with Holmium-YAG laser. RESULTS: The matching parameters were comparable between the 2 groups. The stone-free rates were 88.5% in group 1 and 84.6% in group 2 (P = .566) after a single procedure. The mean operative times for groups 1 and 2 were 32.7 ± 5.8 and 30.2 ± 5.4 minutes, respectively (P = .06). Postoperative hematuria was detected in 1.9% and 13.5% of patients in groups 1 and 2 (P = .027). Ureteral balloon dilation was needed in 1.9% and 15.4% of patients in groups 1 and 2, respectively (P = .015). Mucosal injury was observed in 1.9% and 13.5% of the patients in groups 1 and 2, respectively (P = .027). No major complications were noted in either group. CONCLUSION: Although the stone-free rates and operative times were similar between the 2 groups, a 4.5-6.5F ureteroscope can reduce the need for ureteral balloon dilation and some minor complications, such as mucosal injury and postoperative hematuria, in adult patients.

Retrograde intrarenal surgery for the treatment of renal stones in patients with a solitary kidney.

OBJECTIVE: To evaluate the efficacy and safety of retrograde intrarenal surgery (RIRS) in the treatment of renal stones in patients with a solitary kidney. MATERIALS AND METHODS: From December 2008 to March 2012, 24 patients with a solitary kidney who were treated with RIRS for renal stones were included in the study. All patients were preoperatively evaluated with urine culture, serum biochemistry, urinary ultrasonography, noncontrast computed tomography or intravenous urography, or both. The procedure was considered as successful in patients with complete stone disappearance or fragments <4 mm on computed tomography. Preoperative, operative, and postoperative data of the patients were retrospectively analyzed. The mean serum creatinine levels before and after the procedures were compared using a paired sample t-test. RESULTS: The study included 24 patients with a mean age of 44.41 ± 12.15 years (range, 24-70). The mean stone size was 19.83 ± 5.90 mm (range, 10-35). The mean operative time was 55.83 ± 10.90 minutes (range, 40-75). The success rates were 83.3% and 95.8% after the first and second procedures, respectively. A pigtail stent was placed in all patients. The mean serum creatinine levels before the procedures and at 2 weeks after removal of the pigtail stents were 1.54 ± 0.55 mg/dL (range, 0.7-2.8) and 1.56 ± 0.50 mg/dL (range, 0.9-2.6), respectively (P = .92). Minor complications, classified as Clavien I or II, occurred in 4 patients (16.6%). No major complications (Clavien III-V) occurred in the study group. CONCLUSION: RIRS is an effective and safe procedure that can be used to manage renal stones in patients with a solitary kidney.